Organization
CARTER J MOORE MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARTER J MOORE M.D. (OWNER/PHYSICIAN)
(903) 572-5882
Entity
Organization
Contact information
Practice address
304 W 20TH ST, MOUNT PLEASANT, TX 75455-2328
(903) 572-5882
(903) 572-7330
Mailing address
304 W 20TH ST, MOUNT PLEASANT, TX 75455-2328
(903) 572-5882
(903) 572-7330
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
H6448
TX
207VX0000X
Obstetrics Physician
H6448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N45G
MEDICARE PTAN
—
Enumeration date
06/25/2012
Last updated
01/02/2019
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